Closing the MSK Care Gap in Time for the Silver Tsunami

Musculoskeletal (MSK) care is the largest and most common care category in the U.S.— In fact, nearly 50 percent of Americans will experience MSK pain this year. However, it has long been overlooked in favor of cancer, heart conditions, and other life-threatening issues. 

But MSK pain, and spend, is very real: In 2022, the United States spent nearly $500 billion on direct MSK care, while total economic impact is estimated at nearly $1 trillion. Despite this huge spend, we’ve been avoiding meaningful new MSK care approaches for years. We’ve been kicking the can down the road. 

We’ve now reached the end of that road. Something is coming that demands our immediate attention:

The ‘Silver Tsunami.’

By 2030, every member of the baby boomer generation — nearly 73 million Americans — will be eligible for Medicare. The biggest generation America has ever seen is officially aging, and consuming more MSK care as they do so. We have mountains of data that shows in-person physical therapy is extremely effective for treating MSK conditions, but our system is simply not prepared to absorb this tsunami of increased demand for care.

So what do we do? We think creatively. We leverage software to ease the burdens on, and expand the capacity of, human providers, just as we’ve done in most other areas of life. We know that purpose-built MSK software can add capacity to our overburdened healthcare system. But the core healthcare delivery system in this country—the hospital system—has had challenges in ‘going where the care is’ when it comes to MSK. After all, hospital systems are not software developers. 

The fact remains that there is a critical need to expand access to quality care, and digital care pathways are proven avenues to treat a wide swath of clinically appropriate patients. 

As a result, some technology-enabled service companies have stepped into the gap to offer  digital-only physical therapy services that allow patients virtual visits with a captive virtual provider network. Though these services do help ease access, they don’t effectively address the core MSK problem—capacity. That’s because at their core, they’re still a human-driven service. And they’re drawing from the same limited pool of licensed therapists as hospitals and other brick-and-mortar care providers in order to power their service. 

Moreover, many of these solutions have unintentionally created new issues by siphoning patients away from their local care systems and into digital walled gardens that don’t share data easily. When digital-only patients need to access local care, it’s often a struggle for them to get the data out of their digital health platform and into their provider’s electronic medical record (EMR). And after nearly six years of widespread experimentation with digital-only therapy services companies, we now know that their impact on population health is limited: Only 1 to 2 percent of total patients engage with virtual-only MSK solutions annually. Their direct-to-consumer marketing approach—an approach necessitated by their core strategy of sidestepping existing local care providers—simply cannot engage enough patients to make a difference in overall population health.  

And as the Silver Tsunami gets bigger and stronger each year, these services still haven’t solved the core problem: expanding the capacity of high-quality MSK care. 

What’s needed is a fundamentally different approach. I believe there’s no substitute for high-quality local therapy, and I believe that innovative new solutions must, at their core, empower local caregivers—not disintermediate them. When a patient needs care, they want to speak directly to a healthcare professional, not engage with a marketing flier. 

Intelligent new software platforms that empower local providers to treat a greater number of patients while practicing at the top end of their license – that’s what’s ideal. There are emerging solutions that use computer-vision, artificial intelligence, configurable care protocols, and experience gamification to engage patients and to do many of the lower-value added tasks previously performed by human beings, freeing up clinicians to do what only they can do in-clinic. 

Additionally, EMR integration is critical if clinicians are going to use these new tools. If healthcare providers are fed up with trying to use layer upon layer of new portals, software, apps, and tools, each one requiring “just one more click,” we’re never going to close the last mile gap in MSK care. Effective software must ease a clinician’s workload, not add to it.

There’s no single silver bullet—the problem is complex, and a lot of smart people are working tirelessly to solve it. So far, those solutions have come up short. But by investing in our skilled and talented clinicians and arming them with powerful solutions, we can empower them and drive meaningful change.

Photo: Srisakorn, Getty Images

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